右美托咪定复合椎管内舒芬太尼在剖宫产麻醉中的应用  

Application of dexmedetomidine combined with intraspinal sufentanil in anesthesia for cesarean section

作　　者：李佳蔓 陈晓娟 LI Jia-man;CHEN Xiao-juan(Anesthesia Surgery Center,Ziyang Central Hospital,Ziyang 641300,Sichuan,China)

机构地区：[1]资阳市中心医院麻醉手术中心,四川资阳641300

出　　处：《川北医学院学报》2024年第7期981-984,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨椎管内舒芬太尼联合右美托咪定在剖宫产中的应用效果。方法:选取160例行剖宫产生产的产妇作为研究对象,根据麻醉方式不同将产妇分为观察组(n=81)与对照组(n=79),对照组予以罗哌卡因+舒芬太尼;观察组在对照组基础上予以椎管内右美托咪定麻醉,比较两组产妇术前(T1)、术后4 h(T2)、术后12 h(T3)、术后48 h(T4)时刻镇痛、镇静、泌乳水平,记录并比较产妇不良反应及新生儿结局。结果:观察组产妇在T2、T3及T4时刻静息、运动、宫缩VAS评分均低于对照组(P<0.05);镇静(Ramsay)评分高于对照组(P<0.05)。观察组产妇初次泌乳时间低于对照组(P<0.05);T2、T3及T4时刻PRL水平均高于对照组(P<0.05)。两组产妇不良总反应发生率、神经行为评分与1 min Apgar评分无统计学差异(P>0.05)。结论:右美托咪定复合椎管内舒芬太尼在剖宫产中镇痛及镇静效果较佳,促进泌乳,可为丰富椎管内麻醉下剖宫产术后患者的镇静、镇痛提供有效依据。Objective:To investigate the application effects of dexmedetomidine combined with intraspinal sufentanil in cesarean section.Methods:160 women undergoing cesarean section were selected and assigned to the observation group(n=81)and the control group(n=79)according to different anesthesia methods.The control group was anesthetized with ropivacaine and sufentanil.On this basis,the observation group was given intraspinal anesthesia with dexmedetomidine.The analgesic,sedative and lactation levels before operation(T1),at 4 h after operation(T2),12 h after operation(T3)and 48 h after operation(T4)were comparatively analyzed.Maternal adverse reactions and neonatal outcomes were recorded.Results:At T2,T3 and T4,VAS scores of the observation group in resting state,motor state and uterine contraction state were lower,and Ramsay scores were higher compared to control group(P<0.05).The time to first lactation in the observation group was shorter than that in the control group(P<0.05).At T2,T3 and T4,PRL levels in the observation group were higher than those in the control group(P<0.05).There was no statistically significant difference in the adverse reaction rate,neurobehavioral score,and 1-minute Apgar score between the two groups(P>0.05).Conclusion:Dexmedetomidine combined with intraspinal sufentanil can achieve relatively better analgesic and sedative effects in cesarean section,and promote lactation.It provides an effective method for sedation and analgesia of patients undergoing cesarean section under intraspinal anesthesia.

关 键 词：右美托咪定 椎管内 舒芬太尼 剖宫产 术后镇痛 新生儿结局 

分 类 号：R614.2[医药卫生—麻醉学]